OR Tables: Well Beyond Patient Pedestals

In today’s surgical arena, a surgical table is not simply a pedestal on which to prop up a patient for a procedure. Modern surgical tables, even the most basic models, need to be designed to accommodate advancing OR technologies, imaging requirements, new surgical techniques, the variety in patients’ weights and sizes, and the increasing trend toward integrated surgical suites and healthcare facilities.

Currently, there is no shortage of options for hospitals or surgery centers looking to obtain surgical tables. From basic general purpose tables, to heavy duty full-function tables, to special-procedure tables, to table accessories that accommodate additional procedures, there is an ideal table for virtually any setting. Here is a look at some of the newest tables on the market and a number of accessories that help them meet the needs of the modern OR.

Surgical Tables

“New surgical table designs are created from changing market needs, a pencil, and a raw sheet of stainless steel,” says John Moore, Manager of Professional Services and Business Development for TRUMPF Medical Systems, Inc., a worldwide manufacturer of surgical tables and other surgical systems. Priding itself on developing tables that are safe, superior, and equipped with unique features, TRUMPF currently offers six surgical tables to the US and Canada that cover a broad range of specialty and general surgical procedures. All TRUMPF tables marketed in North America are equipped with electric motors and worm-drive spindle gears, eliminating potential table failures that could stem from hydraulic systems.

The C-Max general surgical table from FHSurgical
boasts the industry high weight capacity of 1,100 pounds.

These tables feature large dual casters that allow for very easy movement, making transport throughout the facility uncomplicated for the hospital staff. They are also telephone modem accessible, which allows for diagnostic and articulating speed adjustments to be made from remote locations throughout the world.

One of TRUMPF’s latest releases is the TITAN, developed specifically for the North American market. Slightly wider than standard full-function surgical tables, the TITAN boasts a weight capacity of up to 1,000 pounds with no weights restrictions attached to any of its numerous attainable articulations or positions. Yet, it is versatile enough to accommodate even pediatric cases. The mobile TITAN can achieve forty degrees of normal and reverse trendelenburg articulation, providing an important tool to surgeons operating on bariatric patients by permitting gravity to move adipose tissue out of the way, revealing the organs to which the surgeons require access.

In addition, TRUMPF has developed its tables to meet the requirements of emerging technologies. Equipped with IR remote control capability, in conjunction with the electrical motor articulation, the tables can be easily integrated with any existing voice activation software. Imaging capabilities are also taken into account. “TRUMPF offers a wide range of carbon fiber table tops and carbon leg and head accessories. Carbon fiber is becoming more important in the OR theater with the increased use of minimum invasive C-Arm procedures. Also, three models have the capability of both longitudinal and transverse sliding capabilities at an affordable price,” says Moore.

requires access.

TWhite Star Medical has the capability to provide custom OR Pads and Positioners to meet the needs of the surgical team.

Skytron is another world leader in the development and manufacturing of surgical tables and systems, with new table models soon to be released. Skytron offers a full menu of surgical tables, with four general purpose tables designed to meet the budgetary and clinical demands of today’s healthcare facilities. Tables designed to accommodate the requirments of specialized procedures are also available, such as the 3000 Series Tables which meet the needs of specialties requiring long imaging windows and radiolucent tabletops, and the 1700 Surgical Table designed specifically for outpatient surgery facilities that may otherwise have considered rebuilt or re-manufactured tables.

In addition, Skytron was a leading force in the development of surgical tables to accommodate the growing number of bariatric patients. “Most surgical table manufactures have attempted to give special attention to the bariatric patient to meet today’s demands for patient handling and positioning. Skytron was the first to address the bariatric patient when the 6500HD Hercules table was introduced in 1994, and has remained committed to that visionary leadership position today with product developments, enhancements, and technological upgrades including optional voice and touchscreen activation,” claims Steve Sterkenburg, Product Manager at Skytron.

This spring, Skytron intends to break new ground in bariatric surgical table design with the introduction of a new Heavy Duty, General Purpose Bariatric table at the AORN 52nd Annual Congress. Combining the best features of the 6500HD and 6600 Series Tables, the new table is designed to meet those needs expressed by surgeons who regularly deal with bariatric patients. Sterkenburg explains, “Our new surgical table promises to be a powerhouse loaded with even greater engineering enhancements to include greater weight capacity, imaging flexibility, speedy set up with fewer required accessories, and other highly and clinically sought after features demanded of today’s modern operating room table. Expanded table functions and lighted pendant control with optional IR remote pendant will promote ease, speed, safety of setups and table adjustments during any case. Table height adjustment range and other key improvements have been added into this table by listening closely to the feedback of our customer clinicians.”

STERIS Corporation also offers a broad range of surgical tables to meet the patient positioning and various other clinical requirements of today’s OR. STERIS’s general surgical table, the Amsco&reg 3085 SP is clinically versatile, user-friendly, and has a weight capacity of up to 1,000 pounds. It is also specially designed to accommodate the requirements of minimally invasive surgical procedures. “STERIS’s HERMES-Ready 3085 SP Table was the first general surgical table to interface MIS integrated control technology. We are now about to launch a new ‘ACT Enabled 3085 SP’ with Advanced Control Technology interface for a broad range of other companies’ MIS control systems,” say Ward Sanders, Senior Product Manager, Surgical Patient Positioning Systems at STERIS.

To further accommodate bariatric patients, STERIS provides an extensive and growing collection of bariatric accessories for the Amsco 3085 SP. A set of eight Bariatric Table Extensions can increase the tables width for larger patients. Also available are the Bariatric Foot Extension, the Split Leg Positioner that enables mid-line abdominal access between the patients legs, Bariatric Power-Lift Stirrups rated to 800 pounds, and the “TLT” Tri-Layer Technology Matters Pads for pressure management .

In addition, STERIS offers a number of surgical tables designed for use in ambulatory surgery, image-guided surgery, and orthopedics, with its image guided surgical table standing out in the market. Another Senior Product Manager, Surgical Patient Positioning Systems for STERIS, Chris Sharpensteen, Explains its appeal, saying, “The SurgiGraphic 6000 Image Guided Surgical Table has become a clear leader in the dedicated image guided table market. The surgeon preferred manual floating versus motorized movement, superior surgeon palm control, up to 83” imaging window and the 500 pound weight capacity has separated this table from all others.”

Skytron’s 6500HD Hercules table was the first to address the special needs of bariatric patients.

With an extensive product line, Getinge USA provides a number of surgical tables to the healthcare market to meet the needs of each facility. “We have one of the broadest line of operating room tables in the industry. We have mobile general surgical tables and fixed columns in the floor that allow for surgical tabletops to be taken on and off which expedites turnover time. We have orthopedic tables, pediatric tables, and bariatric tables. We really have a broader product range that fits the customers needs,” explains Kevin Gilroy, National Sales Director for Surgical Tables and OR Systems at Getinge USA.

The Alphastar Plus and Alphamaxx are Getinge’s general purpose surgical tables, both rated to handle patients of up to 1,000 pounds. The Alphamaxx features a sliding tabletop and can be equipped with dedicated dual articulated split leg attachment. Its table top can also be positioned two inches lower than standard to provide better access for surgeons during bariatric cases. The Alphastar Plus has a fixed top with a single leg plate. Getinge is also currently marketing other Maquet tables to the US.

Looking to the future, Getinge is engaged in helping to build better integrated surgical suites that will allow for both imaging and procedures to be performed right in the operating room. “We have actually partnered in a joint agreement with General Electric. We’ve built OR tables that have transfer tops that will integrate with GE’s MRIs and CTs. We already have this technology in Europe, where we have an integrated CT in the room and our system is compatible. So they can actually do the surgery in the same room where the CT is and move the patient in and out via a track that is built into the floor. Now were taking that technology here to the states and working with GE to make it compatible with MRI,” says Gilroy.

David Scott Company offers a full line of table accessories for patient positioning and pressure management

Another manufacturer of general purpose surgical tables is Berchtold Corporation, which offers the OPERON&reg B810 and OPERON&reg B710. The B810 incorporates a 12-inch longitudinal sliding tabletop so that the patient’s entire body can be imaged without obstructions. The tabletop surface is made of carbon fiber, and the 19-inch table length imaging window is critical to the imaging of wider, heavier patients. The standard design of the B710 provides a full 42 inches of upper body imaging coverage without any additional set-up, though its modular design provides extended imaging by simply attaching the leg section to the back section.

The OPERON tables are also designed to address to positioning problems often associated with bariatric patients. Bob Cyzman, Product Manager, OPERON Surgical Tables at Berchtold offers this advice. “When deciding which surgical table will meet your needs, the highest weight capacity is not always the best choice. Tables claiming 1,000 pound capacity can have limitations such as ‘lift only’ or a ‘500 pound tilt limitation’ so it is important to understand the actual lift and articulation capabilities of each table. The OPERON tables are designed to handle the stated weight capacity with full lift and articulation capabilities. The B810 handles up to a 600 pound patient with full slide in normal or reverse orientation. The B710 fully positions up to 770 pounds in normal orientation.”

With an industry high weight capacity of 1,100 pounds and 900-pound articulation, the C-Max table from FHSurgical is another option for facilities that occasionally deal with larger patients. With a longitudinal slide of an impressive 18 inches, the C-Max also comes equipped with a feature that can help the surgical team protect their investment. Auto Limit Sensors (ALS) are installed on the table to prevent accidental damage to the table during articulation. FHSurgical also offers width extenders and bariatric pads to aid in patient safety and comfort. Additional attachments for the table are soon to become available as well. “This month we are introducing our Orthopedic Upgrade Package,” says Keith Lewis, FHSurgical’s VP of North America Operations. “This product allows C-Max t convert from a general surgery table to a fully functional orthopedic fracture table. It can then be quickly and easily converted back to a general table when the Ortho package is not in use.”

TRUMPF Medical Systems’ TITAN surgical table was developed specifically for the North American market

A leading manufacturer of surgical C-Arm tables, Biodex offers tables for vascular imaging, cardiac imaging, pain care procedures, urology, and brachytherapy. The vascular tables provide the longest available image free area, allowing for more C-Arm imaging access to all parts of the body. With four different table movement controls, the user can utilize any or all of the controllers as they prefer. In addition, Biodex tables employ micro processing controls for all table movement. The control panels provide real time readouts of the tables’ positions, and have the ability to store ten separate table positions that can then be recalled and selected by the user. Easy to use, with no in-service training required, the Vascular and Pain Management tables boast a weight capacity of 500 pounds, while the Urology and Brachytherapy tables can accommodate patients weighing up to 400 pounds.

Surgical Table Accessories

While specialty surgical tables have their place, and are indeed indispensable in certain settings, the current trend in hospitals and surgery centers to use surgical suites for a broad range of general and specialized procedures makes it a budgetary and spatial impossibility to have a dedicated table for each type of procedure. Fortunately, many manufacturers provide accessory packages for their surgical tables that allow them to be used for a variety of procedures. There are also a number of third party manufacturers that supply accessories which can be used on virtually any make or model surgical table. As Ed Gilman, Marketing and Communications Manager for Allen Medical Systems, says, “Your OR table is only as strong as your accessories, especially when it comes to positioning large patients.”

Allen Medical Systems is a developer of a variety of surgical table accessories for patient positioning, with products designed for use in gynecology, laparoscopy, urology, orthopedics, arthroscopy, and bariatrics. Among their most innovative offerings is their line of stirrups, which include the Yellofin, PALPro, and Ultrafin. These stirrup systems utilize the exclusive Biotrac Joint Technology that mimics the natural motion of the hip. The stirrups also provide a single handle control for infinite movement in both abduction/adduction and lithotomy positioning.

Allen Medical Systems’ Ultrafin Stirrups are rated for patients up to 800 pounds.

Among Allen Medical’s other offerings are pressure management table pads, shoulder positioners and leg holders for arthroscopy, imaging extensions which allow standard surgical tables to be used for imaging applications, and the UroCatcher system that can turn a general table into a cysto table. In addition, Allen Medical is now releasing a line of table accessories to accommodate bariatric patients. “We are launching a comprehensive line of new accessories to support your large patient positioning needs. The new line includes armboards, table width extenders, foot boards, security straps, and Nissen straps rated for patients up to 1,000 pounds in weight,” says Gilman.

For patient positioning, safety, and comfort, White Star Medical provides positioners and replacement pads for surgical tables. These pads can be customized to accommodate any surgical table and to meet the needs of individual surgical teams. Engineered with multi-layered protection that includes an integral gel layer, White Star’s latex-free Angel Plus&reg OR Table Pad replacement sets provide both comfort and care. The antimicrobial four-way stretch fabric is hypoallergenic, fluid and moisture resistant, and stain and tear resistant. These table pads offer maximum shear reduction, even pressure distribution, and tissue trauma protection. Replacement pads are also offered for bariatric width extenders and bariatric armboards.

Rycor Medical, Inc. is another supplier of surgical table accessories, offering the largest selection of hand surgery tables in the industry. These hand tables are designed with onboard accessory rail clamps for easy mounting on any manufacturer’s surgical table. This eliminates the need to locate separate clamps for setup. The tables are constructed of a strong material that is both lightweight and radiolucent.

Rycor Medical, Inc. offers the largest selection of Hand Surgery Tables in the industry.

Rycor also offers a line of malleable anesthesia screens. These screens, which utilize the same clamping system as Rycor’s hand tables, attach directly to accessory rails or imaging tables. When bent, they maintain their shape, allowing for custom placement of sterile drapes.

David Scott Company offers cost saving pressure management solutions for OR table pads as well as a full line of Blue Diamond Viscoelastic Polymer Gel Pads and Positioners. David Scott’s unique line of Pressure Management Pads features an exclusive Tri-level design replacement table pad, which consists of an integral layer of Blue Diamond Gel over a layer of doughy soft visco-foam, with a firm supportive base layer. The line of Blue Diamond Polymer products is designed to simulate human fatty tissue. The Polymer products contain no water and can greatly reduce the chance of pressure insults. Blue Diamond Gel pads evenly distribute weight for improved patient circulation and comfort.

The Amsco 3085 SP General Surgery Table from STERIS can be equipped with a set of eight Bariatric Table Extensions to better accommodate larger patients.

New to the David Scott Company product line are the Light Cloud resposable head positioners. The Light Cloud head donut and prone pillow are manufactured of doughy soft visco foam and skin coated for added protection with the ability to be cleaned. David Scott also a offer a cost effective line of private label accessories such as Lift Assisted Stirrups, Shoulder Chairs, Arthroscopic Leg Holders, Candy Cane Stirrups, Armboards, Clark Sockets and Knee Crutches.

All in all, the surgical table is the center of the operating room, geographically and increasingly otherwise. With all of the latest advancements in design and technologies making the surgical staff's job easier, and the patients more comfortable and accessible, it’s in the right place.